title: Intravenous adenosine (adenoscan) versus exercise in the noninvasive assessment of coronary artery disease by SPECT.
abstract: Fifteen patients at a mean age of 58 underwent adenosine and maximal exercise thallium SPECT imaging. All scans were performed 1 week apart and within 4 weeks of cardiac catheterization. SPECT imaging was performed after the infusion of 140 micrograms/kg/min of adenosine for 6 minutes. Mean heart rate increment during adenosine administration was 67 +/- 3.7 to 77 +/- 4.1. Mean blood pressure was 136 +/- 7.2 to 135 +/- 6.2 systolic and 78 +/- 1.8 to 68 +/- 2.6 diastolic. No adverse hemodynamic effects were observed. There were no changes in PR or QRS in intervals. Five stress ECGs were ischemic. No ST changes were observed with adenosine. Although 68% of the patients had symptoms of flushing, light-headedness, and dizziness during adenosine infusion, symptoms resolved within 1 minute of dosage adjustment or termination of the infusion in all but one patient, who required theophylline. Sensitivity for coronary artery detection was 77% and specificity 100%. Concordance between adenoscans and exercise thallium scintigraphy was high (13/15 = 87%). In two patients, there were minor scintigraphic differences. The authors conclude that adenosine is a sensitive, specific, and safe alternative to exercise testing in patients referred for thallium imaging and may be preferable to dipyridamole.
authors.affiliation: Deborah Heart and Lung Center, Browns Mills, New Jersey.
authors.forename: M M
authors.initials: MM
authors.lastname: LaManna
authors.forename: R
authors.initials: R
authors.lastname: Mohama
authors.forename: I L
authors.initials: IL
authors.lastname: Slavich
authors.forename: F J
authors.initials: FJ
authors.lastname: Lumia
authors.forename: S D
authors.initials: SD
authors.lastname: Cha
authors.forename: N
authors.initials: N
authors.lastname: Rambaran
authors.forename: V
authors.initials: V
authors.lastname: Maranhao
mesh_terms: D000241:Adenosine; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005080:Exercise Test; D006801:Humans; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes; D000241:Adenosine